Montana Public Radio

Proposed Montana Medical Schools Raise Questions About For-Profit Model

Jun 10, 2021

Two universities are looking to build medical schools in Montana. One is a nonprofit university that’s awaiting approval to start the accreditation process. A for-profit university has gotten the green light to start going through that procedure.

MTPR’s Freddy Monares spoke to Victoria Knight, a Kaiser Health News reporter, who recently published a story with NPR on the race to open a medical school in the Big Sky state.

Freddy Monares The two school models have triggered questions about training for doctors, how it'll be paid for and if a state like Montana can sustain either models for the medical schools. Victoria is here to explain her reporting. Thanks for joining us today, Victoria. 

Victoria Knight Thank you so much for having me, Freddy. 

Freddy Monares Yeah. Can you give us a little history about for-profit medical schools in the country? 

Victoria Knight So about a hundred years ago, there were just a ton of medical schools in the U.S. Basically, anyone who wanted to open a medical school could at the time. After this was happening for a little bit, the Carnegie Foundation kind of did a report on how many doctors were providing bad quality medical care, and that caused a bunch of states to decide, "We're going to implement accreditation standards, we're going to make medical education standardized." It basically banned the, these for-profit medical schools. That happened about 100 years ago. And then we didn't see for-profit medical schools again until 2008. And that's Rocky Vista University in Colorado. 

Freddy Monares Yeah. Of the privately owned for-profit medical school that wants to establish itself here. Do we know who owns it? 

Victoria Knight So Rocky Vista is the name of the for-profit that wants to open a satellite campus in Montana. It originally, when it first — the 2008 campus opened, it was just a private individual, basically just a rich investor is who originally owned the school. But then it was sold a couple of years ago to a private equity firm. They declined to be a part of the story. So beyond knowing it's a private equity firm, we really don't know much else. 

Freddy Monares OK. Well, what's at stake if students don't know who owns the school they go to? 

Victoria Knight Yeah, you just don't know who's behind it, and along with that, there is just a real lack of transparency with financials. Most schools, private, if they're, even if they're private, if they're nonprofit, most of them will — or all of them really — will share financial reports on their websites of how much money they make from tuition, how much money they get from grants, how much money they get from their operating revenue, and then how much it costs to actually run the school. So with this for-profit model, there are no financial reports on the website like that. So that means students may be paying a lot in tuition, and it's not clear where that tuition money is going. And so that's the, that's the issue is that students that are attending these schools really just won't know what the investors are, how much they're profiting off of them attending these schools. 

Freddy Monares Yeah. I was wondering, too, what ingredients does Montana have that makes it attractive for these schools? 

Victoria Knight Yeah, that's a great question. I asked the schools, yeah, why they chose Montana. I think one of the reasons in part is because you guys don't really have a medical school. I know there is a program with the University of Washington, a relationship where there are students from Montana that can go to medical school with the University of Washington. So there is that program that exists. But outside of that, there is not a medical school in Montana. And also, at least what the schools told me was that there is a real need for more doctors in the state of Montana and in that area of the West. There is this idea that if you go to school in a certain area, then perhaps you will eventually do your residency in the same area and then stay. And so I think those were the things. But I think it's primarily that they see an opportunity to open a school when there really isn't one. 

Freddy Monares Yeah, that's interesting. I'm wondering, too, have regional hospitals or medical providers weighed in on what it could mean to have these new students trained in their backyards? 

Victoria Knight Yeah, that definitely is something that some communities have weighed in on. There is concern that, can the state of Montana handle two medical schools opening? Part of it, opening a medical school, you need to be able to, you know, the first two years you take classes, but then the second two years you do clinical training. So you go in and shadow doctors and, you know, do more hands-on things. So I think there is concern that if two new medical schools opened, both with, I think they both have proposed to have classes of a hundred or so. If that's 200 new students coming in every year, then are there enough doctors in the community for them to shadow and get that clinical training that they have to get as part of their education? And if not, does that mean they're going to have to go outside of the state of Montana to do that instead, which kind of defeats the purpose of opening a school in Montana? 

Freddy Monares What are experts saying about bringing back for-profit medical schools? 

Victoria Knight There are some who say that any type of for-profit institution is really a bad idea, and that is because there really isn't a lot of transparency with a for-profit model on where the funds are going. There are others that say, "Well, these for-profits have to go through the same accreditation process that nonprofit institutions go through. And so they can make it through that process and their standards should be good enough to keep their doors open." It's really a mixed bag, but between. But yeah, it, yeah, it's something to be debated. 

Freddy Monares Does a for-profit model affect loans that students can get to help pay for their education? 

Victoria Knight Yes. When a new for-profit medical school opens, it is beginning the accreditation process, but it cannot be fully accredited until the first class of students graduates. So these students, then, that come into these new for-profit medical schools, they do not qualify for — because the school is not fully accredited — they do not qualify for federal loans. So that means they have to then take out private loans, which often have higher interest rates. 

Freddy Monares Yeah, and obviously there are for-profit medical schools elsewhere in the country. I wonder, do we know how graduates of those schools compare to graduates from nonprofit universities, and how do they feel about their education afterward? 

Victoria Knight So a lot of these are really new schools. So a lot of the data is just not quite there yet on how these students might compare to students from non-profits. I did talk to an alumni of Rocky Vista. He graduated in 2015. He told me he really didn't have an issue with it being a for-profit school. He appreciated that they seemed to take some more nontraditional students. So he was an older student. And so he felt like the school accepted, you know, more nontraditional people. But his one issue was that he did have to take out a lot of loans and he did have to take out one year of those private loans that I mentioned because the school wasn't fully accredited when he started attending it. So that, that definitely was a big concern for him. 

Freddy Monares Thanks for sharing your reporting with us, Victoria. 

Victoria Knight Thank you so much for having me on, Freddy. 

That was Kaiser Health News reporter Victoria Knight talking to MTPR’s Freddy Monares about her report on a for-profit medical school coming to Montana. You can find her full report on our website.